ARKANSAS TECH UNIVERSITY NPI 1588136428

NPI Information

ARKANSAS TECH UNIVERSITY is a general practice in Russellville, AR. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee ARKANSAS TECH UNIVERSITY NPI is 1588136428. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1306 N EL PASO AVE
RUSSELLVILLE, AR
ZIP 72801-814
Phone: (972) 367-4845

The provider's authorized official is Mouzon Bass .
The authorized official title is Administrator/agent and has the following contact phone number (972) 367-4845.

The enumeration date for this NPI number is 12/17/2018 and was last updated on 12/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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